Clinical Research Directory
Browse clinical research sites, groups, and studies.
Performance After Cardiac Ablation in Endurance Athletes for Atrial Fibrillation
Sponsor: University Hospital of Leuven Leuven
Summary
The relationship between exercise and atrial fibrillation (AF) seems to follow a J-shaped curve: while moderate activity reduces AF risk, both insufficient and excessive endurance exercise increase susceptibility. In athletes, standard treatments such as antiarrhythmic drugs often provide only partial symptom control and may impair performance through fatigue, chronotropic incompetence and side effects. Pulmonary vein isolation (PVI) may offer a more definitive therapeutic option but carries risks of atrial fibrosis, stiffening, and altered autonomic regulation, which may also influence exercise capacity. We hypothesize that ablation will have a significant impact-either beneficial or detrimental-on the physical performance of athletes with AF. However, existing evidence is limited to small studies with inconsistent findings, underscoring the need for a dedicated study. This prospective, multicentre interventional study will assess the effects of cardiac ablation in 100 endurance athletes with AF. Participants will undergo comprehensive pre- and post-ablation phenotyping, including electrocardiogram (ECG), cardiopulmonary exercise testing (CPET), echocardiography, Holter monitoring, and detailed training data collection (efficiency factor, acute and chronic training load). Clinical follow-up will extend to 12 months post-ablation. The primary endpoint is the change in peak VO₂ (mL/kg/min) measured before ablation and after the procedure. Secondary analyses will explore: * Autonomic adaptations: including changes in maximum heart rate, heart rate recovery, heart rate reserve, and heart rate variability. * Cardiac function: alterations in diastolic and atrial function assessed by echocardiography. * Training and performance: objective measures such as efficiency factor, decoupling, functional threshold power, critical power, and acute and chronic training load. * Technique comparison: differences in outcomes between pulsed field and radiofrequency ablation (e.g. atrial function, troponin release, …). * Sex-specific effects: recognising the underrepresentation of women in sports cardiology research, we will include female athletes according to incidence and evaluate potential differences in treatment response between sexes. * Predictors of AF recurrence in endurance athletes
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
100
Start Date
2026-03-01
Completion Date
2032-12-31
Last Updated
2026-07-24
Healthy Volunteers
No
Conditions
Interventions
Ablation
The ablation procedure will be limited to pulmonary vein isolation (PVI) alone, without additional extensive ablation such as posterior wall, isthmus, or linear lesions on the left or right atrium. If atrial flutter is documented in the patient's medical history, or if it is strongly suspected or inducible during the electrophysiology study, a cavotricuspid isthmus (CTI) ablation will be performed. The choice of energy modality (e.g., pulsed field ablation, cryoablation, or radiofrequency ablation) will be at the discretion of the electrophysiologist, according to procedural goals and institutional standards. When deemed appropriate by the treating physician, an assessment of the underlying arrhythmogenic substrate using electroanatomical mapping may be undertaken; however, this is not mandatory. Similarly, if available and preferred by the participating centre, intra-atrial pressures may be recorded, though this is also optional. Following the ablation, a one-month blanking period wil
Locations (5)
St. Vincent's Hospital
Melbourne, Australia
Universitair Ziekenhuis Antwerpen
Antwerp, Antwerpen, Belgium
ZOL Genk
Genk, Limburg, Belgium
Jessa Hospital, Department of Cardiology
Hasselt, Limburg, Belgium
UZ Leuven
Leuven, Vlaams-Brabant, Belgium